Abstract: Urinary track calculi or urinary stones, formed from crystalized chemicals in the urine such as calcium oxalate, uric acid and cystine, occur in one of ten Canadians in their lifetime. The obstruction of the urinary tract by calculi at the narrowest anatomical areas leads to impaired drainage and severe pain (renal colic). The treatment of renal colic includes conservative treatment including rehydration, analgesia, and drugs to enhance stones expulsion, and surgical treatments such as uteroscopy, percutaneous nephrolithotomy and open/laparoscopic lithotomy. Pain therapy includes drugs such as paracetamol, narcotics, corticosteroids, and acupuncture. Drugs that enhance expulsion include cyclooxygenase inhibitors, corticosteroids, alpha-blocker therapy, or calcium-channel blocker therapy. The stone composition, size and location are key determinants for predicting spontaneous stone passage and therefore dictate the type of therapy used. Stones less than 5mm in diameter and located in the distal ureter are more likely to pass spontaneously with facilitation from drugs that enhance expulsion than larger stones and stones that are located in the proximal ureter which need surgical therapy. Small stones can also be treated with extracorporeal shock wave lithotripsy. The economic burden of urinary stone treatment is estimated at US$5 billion including direct and indirect costs in 2005. Because of the great variability in renal colic management, this Rapid Response report aims to review the comparative clinical and cost-effectiveness of different treatment strategies of renal colic.

Abstract: To update its 1996 guidelines, the U.S. Preventive Services Task Force (USPSTF) commissioned this brief update of the evidence on selected questions about screening for iron deficiency anemia (IDA) in children, adolescents, and pregnant women. We searched relevant databases, Web sites, journals, and reference lists for systematic reviews, epidemiologic surveys, and controlled trials published in 1995 or later that contained new information about the prevalence, diagnosis, natural course, or treatment of iron deficiency anemia in asymptomatic persons in developed countries. One investigator rated the quality of included trials and summarized their results in tables. In the U.S., the average prevalence IDA in target groups is: Infants 1-2 years (6 to 17 per 1000), teenage girls (1.5%), nonpregnant females of reproductive age (2% to 5%). Factors associated with a higher prevalence include prematurity and low birth weight, black or Mexican-American race, Alaskan native heritage, recent immigration, poverty and, among teenage girls, fad dieting or obesity. The prevalence among pregnant women is not known. For cognitive and school outcomes, trials of iron supplementation for iron deficiency anemia have had mixed results. Most trials conducted in high-risk groups within developed countries did not demonstrate any benefit for infants and preschool children, but one trial in high-risk infants demonstrated a transient benefit.